California · Workers' Compensation
When Can You Get a Different QME Panel in California?
Generally, no, not just because you disagree with what the first report says. California only lets you replace a QME panel or evaluator for specific, listed reasons, such as a conflict of interest, the wrong medical specialty, a scheduling delay, or a late report. Those requests use DWC Form 31.5. A second form, Form 31.7, covers an additional panel in a different specialty once a new medical dispute comes up, not a second opinion on the same one.
Eman Yazdchi, Esq., Certified Specialist in Workers' Compensation Law, California Board of Legal Specialization, State Bar of California.
California Board of Legal Specialization, State Bar of California
California Board of Legal Specialization, State Bar of California
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Is a different QME panel available in California?
Not just because you dislike the result. California lets you replace a QME panel or evaluator only for specific, listed reasons, and a separate form covers an additional panel in a new specialty. Disagreeing with the findings themselves is a different problem, with its own set of tools.
By the time this question comes up, you usually already have a panel, an exam, or even a report in hand, and you want to know whether the law lets you start over with someone else.
Sometimes it does. The law lists real, specific situations where a replacement panel or an additional panel is available, and this guide walks through each one, with the actual form it uses. If what you really mean is that the report came back bad and you want to know what to do about it, the tools are different; our guide to challenging a bad QME report covers that question instead.
This page stays narrow, on purpose: when the law lets you swap out the panel or the evaluator itself, and how to ask for it.
What are the real grounds for a QME replacement panel?
Title 8, section 31.5 lists sixteen specific situations where a replacement QME or panel has to be issued on request, filed on DWC Form 31.5. Disliking the outcome is not one of them.
Title 8 of the California Code of Regulations, section 31.5 sets out the only situations where a replacement is available on request. Here is the full list, grouped by what each one is really about.
| Ground | What it covers |
|---|---|
| Wrong specialty | A QME on the panel does not practice in the specialty the requesting party asked for |
| Scheduling delay | The QME cannot schedule your exam within 90 days, or 120 days if that limit was waived |
| You changed residence | You moved after the panel issued, before your first evaluation |
| Same practice group | Two QMEs on the panel belong to the same group practice |
| Evaluator unavailable | The QME is unavailable under the regulations' own unavailability rule |
| Prior evaluator gone | The doctor who already reported in the case can no longer act |
| Prior treating doctor | A QME on the panel already treated you for the same injury |
| Mutual convenience | You and the claims administrator agree in writing to a new panel near your workplace |
| Medical Director good cause | The Medical Director finds good cause tied to the medical or psychological nature of the injury |
| Specialty reviewed and rejected | The Medical Director reviews your records and finds the chosen specialty does not fit the dispute |
| Appointment notice violation | The evaluator broke the appointment notification or cancellation rule; raised within 15 days of finding out |
| Late report | The evaluator missed the report deadline, and you objected to the lateness in writing before the report arrived |
| Disqualifying conflict | The QME has a disqualifying conflict of interest, as the regulations define that term |
| Administrative Director order | The Administrative Director has ordered an additional QME evaluation under section 10164(c) |
| Evaluator will not proceed | The evaluator appears qualified but refuses to give a complete evaluation or a written statement explaining why it cannot address a disputed issue |
| Panel older than 24 months | The panel list is more than 24 months old and no QME on it has examined the worker |
Each ground needs its own supporting facts, not a general complaint. A late report, for example, needs a written objection sent before the report shows up, not after you read it and decided you did not like it. Our guide to Labor Code 4062.5 covers that specific, time sensitive process in full.
How is an additional panel different from a replacement panel?
A replacement fixes a problem with the panel or evaluator you already have. An additional panel, requested on Form 31.7, is for a brand new medical dispute that needs a different specialty, after a report has already come back.
Title 8, section 31.7 covers a narrower, later situation. A QME, an Agreed Panel QME, or an AME has already issued a full report, and a new medical dispute now calls for a different specialty, not a second look at the same question. The regulation expects the parties to return to that same evaluator for a follow up or supplemental opinion whenever that is realistic. An additional panel in a new specialty is available only with one of the following:
- a written agreement between a represented worker and the employer on the need for the new specialty,
- a referral from an acupuncturist raising a disputed disability issue,
- a workers' compensation judge's order naming or directing the new specialty, or
- for an unrepresented worker, an agreement reached with the help of a DWC Information and Assistance officer.
Form 31.7 sits behind that specific request. It is not a route to a second doctor's opinion on the same disputed issue your current QME already addressed.
Does improper contact with the QME let you ask for a new one?
Yes. If the other side communicates with the evaluator outside the required written, served process, you can choose to end that evaluation and start again with a new one.
Labor Code section 4062.3 requires every substantive communication with a panel QME to be in writing and served on the opposing side. A violation of that rule is called an ex parte communication. The party who was not part of the improper contact can then choose to terminate that evaluation and seek a new one under the regular panel process, rather than continue with an evaluator whose neutrality is now in doubt.
What if the report itself is just wrong or unfavorable, not the panel?
That is a different problem with its own set of tools. A supplemental report request, a deposition, a treating doctor's counter opinion, or a factual correction letter work on a report's content, not on the panel that produced it.
None of the grounds above turn on whether you agree with the medical conclusions. If the real concern is the substance of what the evaluator wrote, see our guide to challenging a bad QME report and what happens after a QME exam for the tools built for exactly that question.
How do you actually request a replacement or an additional panel?
Identify the one ground that genuinely fits, then file the matching form, 31.5 for a replacement or 31.7 for an additional panel, with whatever documentation that ground requires.
Both forms come from the Division of Workers' Compensation Medical Unit. The request has to spell out the specific ground, not a general objection, along with its supporting paperwork: a written lateness objection, a copy of a written agreement, or a judge's order, depending on which box applies. Our guide to QME Forms 105 and 106 covers the original panel request that these two forms build on.
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Sorting out a QME panel problem in the Antelope Valley and beyond
Matching the right ground to the right form is the difference between a fast fix and a wasted request.
Yazdchi Law P.C. reviews QME panel and evaluator problems for injured workers across the Antelope Valley, the San Fernando Valley, and the greater Los Angeles area, from its Palmdale office.
Call (661) 273-1780 or use the contact form to talk through your panel, your deadlines, and which option actually fits your situation. The firm reviews each matter individually.
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Frequently Asked Questions
Can I get a second QME panel if I disagree with the first one?
Not simply for disagreeing with it. A new panel requires one of the specific grounds the regulations list, such as a conflict of interest, a scheduling problem, or a late report. If the only issue is the medical conclusion itself, a supplemental request, a deposition, or a treating doctor's counter opinion is the right tool instead.
What is DWC Form 31.5 used for?
Form 31.5 requests a replacement QME or a replacement panel when one of the sixteen listed grounds in Title 8, section 31.5 applies, such as the wrong specialty, a scheduling delay, or a disqualifying conflict of interest.
What is DWC Form 31.7 used for, and how is it different from Form 31.5?
Form 31.7 asks for an additional panel in a different medical specialty once a new dispute comes up after a report has already issued. Form 31.5 fixes a problem with the panel you already have. Form 31.7 adds a new one for a new question in a different specialty.
If I move to a new city, can that get me a new QME panel?
Yes, if you changed your residence after the panel was issued and before your first evaluation. That is one of the listed grounds for a replacement panel under Title 8, section 31.5.
What if the QME cannot schedule my exam for months?
A QME who cannot schedule your exam within 90 days of the initial request, or 120 days if that limit was waived, is its own ground for a replacement under section 31.5.
Can I get a new panel if a doctor on it already treated me?
Yes. A QME who was already your treating physician or secondary physician for the same injury is a disqualifying situation under section 31.5, and a replacement is available on request.
Does a replacement panel restart my 10 day strike deadline?
Title 8, section 31.5(b) tolls, meaning pauses, the 10 day selection or strike period under Labor Code 4062.1 or 4062.2 until the new QME name or panel is actually issued, rather than letting that clock run out while you wait.
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